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Advances in Addressing Patient Heterogeneity in Economic Evaluation: A Review of the Methods Literature.
Shields, Gemma E; Clarkson, Paul; Bullement, Ash; Stevens, Warren; Wilberforce, Mark; Farragher, Tracey; Verma, Arpana; Davies, Linda M.
Afiliación
  • Shields GE; Manchester Centre for Health Economics, Division of Population Health, Health Services Research, and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Centre for Health Economics, University of Manchester, Manchester, UK. gemma.shields@manchester.ac.uk.
  • Clarkson P; Social Care and Society, Division of Population Health, Health Services Research, and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
  • Bullement A; Delta Hat Ltd, Nottingham, UK.
  • Stevens W; Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield, UK.
  • Wilberforce M; Medicus Economics, Boston, MA, USA.
  • Farragher T; Social Policy Research Unit, Department of Social Policy and Social Work, University of York, York, UK.
  • Verma A; Centre for Biostatistics, Division of Population Health, Health Services Research, and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
  • Davies LM; The Epidemiology and Public Health Group (EPHG), Division of Population Health, Health Services Research, and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
Pharmacoeconomics ; 42(7): 737-749, 2024 Jul.
Article en En | MEDLINE | ID: mdl-38676871
ABSTRACT
Cost-effectiveness analyses commonly use population or sample averages, which can mask key differences across subgroups and may lead to suboptimal resource allocation. Despite there being several new methods developed over the last decade, there is no recent summary of what methods are available to researchers. This review sought to identify advances in methods for addressing patient heterogeneity in economic evaluations and to provide an overview of these methods. A literature search was conducted using the Econlit, Embase and MEDLINE databases to identify studies published after 2011 (date of a previous review on this topic). Eligible studies needed to have an explicit methodological focus, related to how patient heterogeneity can be accounted for within a full economic evaluation. Sixteen studies were included in the review. Methodologies were varied and included regression techniques, model design and value of information analysis. Recent publications have applied methodologies more commonly used in other fields, such as machine learning and causal forests. Commonly noted challenges associated with considering patient heterogeneity included data availability (e.g., sample size), statistical issues (e.g., risk of false positives) and practical factors (e.g., computation time). A range of methods are available to address patient heterogeneity in economic evaluation, with relevant methods differing according to research question, scope of the economic evaluation and data availability. Researchers need to be aware of the challenges associated with addressing patient heterogeneity (e.g., data availability) to ensure findings are meaningful and robust. Future research is needed to assess whether and how methods are being applied in practice.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Análisis Costo-Beneficio Límite: Humans Idioma: En Revista: Pharmacoeconomics Asunto de la revista: FARMACOLOGIA / TERAPIA POR MEDICAMENTOS Año: 2024 Tipo del documento: Article Pais de publicación: Nueva Zelanda

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Análisis Costo-Beneficio Límite: Humans Idioma: En Revista: Pharmacoeconomics Asunto de la revista: FARMACOLOGIA / TERAPIA POR MEDICAMENTOS Año: 2024 Tipo del documento: Article Pais de publicación: Nueva Zelanda